Laxatives and enemas: not the way to go

By abusing laxatives and enemas, some people
with eating disorders try to rush food through their bodies before
the calories can be absorbed. These practices are harmful, even
potentially fatal, and they don't work to remove calories.

I have been using laxatives and enemas
to control my weight. My mother says I am putting myself in danger.
Is she just trying to control me?

Listen to your mother. This time she is
right

Laxatives and enemas have no place in
modern health care except in medical conditions monitored by
physicians.

People with eating disorders abuse laxatives
because they believe they can remove food from their bodies before
the calories are absorbed (They can't. See below.) Also, many
are constipated. The little bit of food they allow themselves
does not provide enough bulk to stimulate regular bowel movements.

Many people can kick the laxative/enema
habit, even after long-term use. To manage problems, work with
a physician.

Why can't laxatives help me control
my weight? After I use the bathroom, I always weigh less than
I did before.

A healthy bowel receives food residue from
the stomach and small intestine. As the bowel fills, fecal matter
stimulates nerve endings, causing muscle contractions that expel
the residue from the body in a bowel movement.

Laxatives and enemas artificially stimulate
nerve endings in the large bowel, which is also called the colon.
The colon is one of the last structures in the digestive tract.
By the time food arrives there, nothing is left but indigestible
fiber and other non-nutritive material.

Laxatives remove lots of water from the
colon as well as food residue. The scales indicate weight loss
after a laxative-induced bowel movement, but it is false weight
loss. The ounces or pounds return as the body rehydrates after
liquid intake consumption. If the person refuses to drink liquids,
s/he risks dehydration which can lead to fainting spells and
in some cases death.

Laxatives and enemas cannot stimulate the
small intestine, the part of the GI tract where food is digested
and where nutrients and calories are absorbed. The small intestine
does not even have the kinds of nerves that occur in the colon
and respond to artificial stimulation.

In one experiment, a group of laxative
abusers ate a high calorie meal. A group of normal people ate
the same food, which totaled several thousand calories. The laxative
abusers took their purgatives of choice. The normal people let
nature take its course. Researchers collected all the material
passed in bowel movements and tested it for calorie content.
Even after consuming thousands of calories and massive amounts
of laxatives, the laxative abusers managed to remove only about
100 extra calories from their bodies, the amount found in one
small cookie.

How can I hurt myself my continuing
to use laxatives and enemas?

You can upset your electrolyte balance.
Electrolytes are minerals like sodium, potassium that are dissolved
in the blood and other body fluids. They must be present in very
specific amounts for proper functioning of nerves and muscles,
including the heart muscle.

Laxatives and enemas (and also vomiting)
remove needed fluid from the body. The resulting dehydration
can lead to tremors, weakness, blurry vision, fainting spells,
kidney damage, and in some cases death. Severe dehydration requires
medical treatment. Drinking fluid may not hydrate cells and tissues
quickly enough to prevent organ damage or death.

Laxatives irritate intestinal nerve endings,
which in turn stimulate muscle contractions that move the irritant
through the gut and out of the body. After a while the nerve
endings no longer respond to stimulation. The person must now
take greater and greater amounts of laxatives to produce bowel
movements. S/he has become laxative dependent and without them
may not have any bowel movements at all.

Laxatives and enemas strip away protective
mucus that lines the colon, leaving it vulnerable to infection.

Enemas can stretch the colon, which over
time becomes a limp sack with no muscle tone. No longer can it
generate the muscle contractions necessary to move fecal matter
out of the body.

Laxatives abusers seem to have more trouble
with the following problems than do nonusers: irritable bowel
syndrome (rectal pain, gas, and episodes of constipation and
diarrhea) and bowel tumors (both benign and cancerous).

As your doctor advises, either taper off
or go cold turkey. Expect to be anxious when time passes with
no bowel movement and increasing feelings of fullness, bloat,
and discomfort. Your body needs time to regulate itself and relearn
how to respond to natural cues. Be reassured that most people
who stick with their doctor's recommendations manage to stop
laxatives and enemas and resume normal functioning after an initial
period of discomfort.

Make sure you eat enough food, especially
high-fiber items like whole grains, fresh fruits, and fresh vegetables.
Eat the skin and peels too; they are usually high in fiber. An
inexpensive, effective way to increase fiber in your diet is
to add a few spoonfuls of unprocessed bran to soups, stews, and
cereals. Don't go overboard with bran, however. It can generate
intestinal gas which will increase your discomfort.

Drink a hot beverage (lemon juice in hot
water is good), and then walk briskly for thirty minutes. The
hot liquid and muscle movements in your legs and abdomen will
help stimulate muscle contractions in the intestines.

Drink lots of water during the day. Doctors
recommend eight to ten glasses. Don't count caffeine beverages
in your total; caffeine pulls water out of your body instead
of adding it to cells and tissues.

Before breakfast, take a walk. Walking
gets your intestinal muscles working so they can move the contents
of your GI tract along and out of your body. A cup of hot water
and lemon juice helps get things going too.

Eat breakfast! After breakfast, sit on
the toilet for 5-10 minutes. Breakfast initiates a reflex that
triggers the intestines to evacuate their contents.

Let your therapist help you deal with
the anxiety that this recovery process may create. Remember that
the human body has tremendous powers of restoration, but they
sometimes take a while to kick in. Best wishes for health and
happiness.

Please Note: ANRED information is not a substitute for medical
or psychological evaluation and treatment. For help with the
physical and emotional problems associated with eating disorders,
talk to your physician and a mental health professional.